Featured Research

from universities, journals, and other organizations

Experts recommend universal screening of newborns for congenital adrenal hyperplasia

Date:
September 7, 2010
Source:
The Endocrine Society
Summary:
The Endocrine Society has released a new clinical practice guideline on the diagnosis and treatment of congenital adrenal hyperplasia. The guideline features a series of evidence-based clinical recommendations developed by an expert task force.

The Endocrine Society has released a new clinical practice guideline on the diagnosis and treatment of congenital adrenal hyperplasia (CAH). The guideline features a series of evidence-based clinical recommendations developed by an expert task force.

The guideline, published in the September 2010 issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society, is endorsed by the American Academy of Pediatrics, Pediatric Endocrine Society, the European Society for Paediatric Endocrinology, the European Society of Endocrinology, the Society for Pediatric Urology, the Androgen Excess and PCOS Society, and the CARES Foundation.

CAH is a genetic disorder of the adrenal glands that affects about one in 10,000 to 20,000 newborns, both male and female. The adrenal glands make the steroid hormones cortisol, aldosterone and androgens. In individuals with CAH, the adrenal glands produce an imbalance of these hormones which can result in ambiguous genitalia in newborn females, infertility and the development of masculine features such as development of pubic hair, rapid growth in both girls and boys before the expected age of puberty.

"If CAH is not recognized and treated, both girls and boys undergo rapid postnatal growth and early sexual development or, in more severe cases, neonatal salt loss and death," said Phyllis Speiser, MD, of Cohen Children's Medical Center of New York and Hofstra University School of Medicine, and chair of the task force that developed the guideline. "We recommend that every newborn be screened for CAH and that positive results be followed up with confirmatory tests."

Other recommendations from the guideline include:

  • Prenatal treatment of CAH should continue to be regarded as experimental. Such therapies should be pursued through protocols approved by Institutional Review Boards at centers capable of collecting outcomes data on a large number of patients so that risks and benefits of this treatment can be defined more precisely;
  • Diagnosis should rest on clinical and hormone data while genotyping should be reserved for equivocal cases and genetic counseling;
  • Regarding treatment, glucocorticoid dosage should be minimized to avoid iatrogenic Cushing's Syndrome. Mineralcorticoids and, in infants, supplemental sodium are recommended in classic CAH patients;
  • Clinicians should avoid the routine use of experimental therapies to promote growth and delay puberty, and patients should avoid adrenalectomy;
  • Early single-stage genital repair should be considered for severely virilized girls and should be performed only by surgeons experienced in this type of procedure;
  • Clinicians should consider patients' quality of life, consulting mental health professionals as appropriate;
  • At the transition to adulthood, clinicians should monitor for potential complications of CAH; and
  • Clinicians should exercise judicious use of medication during pregnancy and in symptomatic patients with nonclassic CAH.

"People with classic CAH should have a team of health care providers, including specialists in pediatric endocrinology, pediatric urologic surgery (for girls), psychology and genetics," said Speiser. "Other than having to take daily medication, people with classic CAH can have a normal life."

The Hormone Foundation, the patient education affiliate of The Endocrine Society, has published a new bilingual fact sheet about congenital adrenal hyperplasia for patients. It defines CAH and explains how the condition is diagnosed and treated. The fact sheet can be found online at: http://www.hormone.org/Resources/upload/congenital-adrenal-hyperplasia-bilingual-081310.pdf.

Other members of the task force that developed this guideline include: Ricardo Azziz of Cedars-Sinai Medical Center in Los Angeles, Calif.; Laurence Baskin and Walter Miller of the University of California San Francisco; Lucia Ghizzoni of the University of Turin in Italy; Terry Hensle of Columbia University in New York, N.Y.; Deborah Merke of the National Institutes of Health Clinical Center; Heino Meyer-Bahlburg of New York State Psychiatric Institute in New York, N.Y.; Victor Montori of Mayo Clinic in Rochester, Minn.; Sharon Oberfield of Columbia University College of Physicians & Surgeons in New York, N.Y.; Martin Ritzen of Karolinska Institute in Stockholm, Sweden; and Perrin White of the University of Texas Southwestern Medical Center in Dallas.


Story Source:

The above story is based on materials provided by The Endocrine Society. Note: Materials may be edited for content and length.


Cite This Page:

The Endocrine Society. "Experts recommend universal screening of newborns for congenital adrenal hyperplasia." ScienceDaily. ScienceDaily, 7 September 2010. <www.sciencedaily.com/releases/2010/09/100907071244.htm>.
The Endocrine Society. (2010, September 7). Experts recommend universal screening of newborns for congenital adrenal hyperplasia. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2010/09/100907071244.htm
The Endocrine Society. "Experts recommend universal screening of newborns for congenital adrenal hyperplasia." ScienceDaily. www.sciencedaily.com/releases/2010/09/100907071244.htm (accessed October 2, 2014).

Share This



More Health & Medicine News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Robotic Hair Restoration

Robotic Hair Restoration

Ivanhoe (Oct. 1, 2014) A new robotic procedure is changing the way we transplant hair. The ARTAS robot leaves no linear scarring and provides more natural results. Video provided by Ivanhoe
Powered by NewsLook.com
Insertable Cardiac Monitor

Insertable Cardiac Monitor

Ivanhoe (Oct. 1, 2014) A heart monitor the size of a paperclip that can save your life. The “Reveal Linq” allows a doctor to monitor patients with A-Fib on a continuous basis for up to 3 years! Video provided by Ivanhoe
Powered by NewsLook.com
Attacking Superbugs

Attacking Superbugs

Ivanhoe (Oct. 1, 2014) Two weapons hospitals can use to attack superbugs. Scientists in Ireland created a new gel resistant to superbugs, and a robot that can disinfect a room in minutes. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins